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Insights into Imaging

Table 1 Imaging findings of extramural venous invasion

From: MRI-detected extramural venous invasion of rectal cancer: Multimodality performance and implications at baseline imaging and after neoadjuvant therapy

Pulse sequences or modality

Findings contiguous with primary tumor

T2WI

Intermediate signal intensity with slightly expanded vessels (score 3) or nodular, bead- or worm-shaped structure irregular margin (score 4)

DWI

Intermediate to high signal intensity in the expanded vessels at the site consistent with findings on T2WI

CE-T1WI

Filling defect in the vessel, +/- vessel dilation

Tumor signal intensity within  the expanded vessel (s)

CT

Heterogeneously enhancing, serpentine, cord-like expanded structure with irregular margin

  1. These findings contiguous with the primary lesion invading beyond the muscularis propria
  2. CE-T1WI, contrast enhanced T1-weighted image; DWI, diffusion-weighted image; T2WI, T2-weighted image
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